Utility of the Montreal Cognitive Assessment and Mini-Mental State Examination in Predicting General Intellectual Abilities

Objective: To determine whether scores from 2 commonly used cognitive screening tests can help predict general intellectual functioning in older adults. Background: Cutoff scores for determining cognitive impairment have been validated for both the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). However, less is known about how the 2 measures relate to general intellectual functioning as measured by the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Methods: A sample of 186 older adults referred for neuropsychological assessment completed the MoCA, MMSE, and WAIS-IV. Regression equations determined how accurately the screening measures could predict the WAIS-IV Full Scale Intelligence Quotient (FSIQ). We also determined how predictive the MoCA and MMSE were when combined with 2 premorbid estimates of FSIQ: the Test of Premorbid Functioning (TOPF) (a reading test of phonetically irregular words) and a predicted TOPF score based on demographic variables. Results: MoCA and MMSE both correlated moderately with WAIS-IV FSIQ. Hierarchical regression models containing the MoCA or MMSE combined with TOPF scores accounted for 58% and 49%, respectively, of the variance in obtained FSIQ. Both regression equations accurately estimated FSIQ to within 10 points in > 75% of the sample. Conclusions: Both the MoCA and MMSE provide reasonable estimates of FSIQ. Prediction improves when these measures are combined with other estimates of FSIQ. We provide 4 equations designed to help clinicians interpret these screening measures.